Tocilizumab in Behçet Disease: A Multicenter Study of 30 Patients.

J Rheumatol

M.Y. Khitri, MD, A. Bartoli, MD, G. Maalouf, MD, M. Vautier, MD, P. Cacoub, MD, PhD, D. Saadoun, MD, PhD, Department of Internal Medicine and Clinical Immunology France, Centre National de Référence Maladies Autoimmunes Systémiques Rares, Centre National de Référence Maladies Autoinflammatoires et Amylose, and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Université, AP-HP, Hôpital Pitié Salpetrière, Paris, France;

Published: July 2023

Objective: To evaluate tocilizumab (TCZ) efficacy in patients with refractory Behçet disease (BD).

Methods: This is a multicenter study of 30 patients fulfilling the international criteria for BD and treated with TCZ at different European referral centers. The clinical response was evaluated at 6 months from TCZ initiation.

Results: Ninety percent of patients with BD were refractory or intolerant to anti-tumor necrosis factor (anti-TNF) agents. Overall, TCZ was effective in 25 (83%) patients with BD of whom 18 (60%) and 7 (23%) were complete and partial responders, respectively. The complete response was 67%, 60%, and 42% in patients with uveitis (18/30), neurological manifestations (5/30), and mucocutaneous and/or articular (7/30) manifestations, respectively. TCZ had a significant steroid-sparing effect allowing patients to decrease their median daily prednisone dose from 20 (IQR 10-40) mg/day to 9 (IQR 5-13) mg at 6 months ( < 0.001). The number of patients with BD needing concomitant disease-modifying antirheumatic drug therapy fell from 7 (23%) to 4 (13%) at 6 months. Mild to moderate side effects were observed in 6 (20%) patients, and 3 (10%) presented with serious adverse events (pneumonia, intestinal perforation, and septicemia) requiring therapy discontinuation in 2 cases.

Conclusion: TCZ seems to be an effective alternative to anti-TNF agents in treating BD-related uveitis and neurological manifestations.

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Source
http://dx.doi.org/10.3899/jrheum.221106DOI Listing

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